Billing code 64462: Paravertebral blockMedicare rate & RVUs in Texas
Report this add-on for each additional thoracic paravertebral injection site beyond the first during a session using single-injection blocks.
Medicare pays $74.39–$80.23 for 64462 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 64462 covers
This add-on represents an additional thoracic paravertebral injection site using anesthetic and/or steroid, beyond the first site. Anesthesiologists and pain specialists commonly perform these blocks for perioperative pain control in thoracic surgery or for chest-wall analgesia. The service may be performed in an operating room, procedure suite, or other setting where regional anesthesia is provided.
Report 64462 only with the primary single-site thoracic paravertebral injection code, 64461; it is not a standalone service. Documentation should identify the thoracic paravertebral block, the additional injection site or sites, and the clinical purpose. CMS pays this add-on within the primary procedure’s global period. When the service is reported as bilateral with modifier 50, CMS pays it at 150%.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 64462 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$74.39 to $80.23
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $80.23 | $44.54 |
| Beaumont | $74.39 | $43.69 |
| Brazoria | $77.50 | $44.07 |
| Dallas | $77.94 | $44.34 |
| Fort Worth | $77.58 | $44.32 |
| Galveston | $77.71 | $44.21 |
| Houston | $79.17 | $45.67 |
| Rest Of Texas | $75.87 | $43.86 |
How the 64462 rate is calculated
Each of 64462’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 64462
RVUs × geographic indexes × conversion factor
Work1.07
1.07 RVUs× 1.000 GPCI
Practice expense1.19
1.19 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
2.3400
Conversion factor
$33.4009
Medicare rate
$78.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64462
The CMS indicators that decide how 64462 is paid alongside other services.
CMS payment indicators · 64462
Paravertebral block
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
64462 without 50 · national office
$78.16
Paravertebral block
64462-50 · Bilateral: 150%
$117.24
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
64462 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 64461Paravertebral block
- 64461 reports the first thoracic paravertebral injection site; 64462 is the add-on for each additional site and cannot stand alone.
- 64463Paravertebral block
- Use 64463 for a thoracic paravertebral continuous infusion through a catheter, rather than additional single-injection sites.
- 64466Thoracic block
- 64466 describes a unilateral thoracic fascial plane block by injection. Choose it when that fascial plane technique is performed, not a paravertebral injection.
- 64468Thoracic block
- 64468 describes a bilateral thoracic fascial plane block by injection; 64462 applies to additional thoracic paravertebral injection sites.
64462 billing questions
Can 64462 be billed by itself?
No. It is an add-on code and must be reported with 64461 for the first thoracic paravertebral injection site.
How is 64462 distinguished from 64461?
64461 represents the first injection site. Report 64462 for each additional thoracic paravertebral injection site in the session.
When should 64463 be used instead?
64463 describes a thoracic paravertebral block delivered by continuous infusion through a catheter. 64462 is for additional sites in a single-injection service.
What should the record support?
Document the thoracic paravertebral technique, the additional site or sites treated, and the reason for the block, such as perioperative or chest-wall pain control.
How does CMS handle bilateral reporting?
CMS pays the bilateral procedure at 150% when modifier 50 is reported.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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